8 Things to Do When Your Parent Refuses Assisted Living

Updated

Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

You may have thought that the best way to help convince your parent that assisted living is the right place to go is through long-term care planning.

By couching the discussion in the context of a long-range plan, it might be a more accessible option. You may have even had these discussions with your parent long ago, but now they are refusing to honor what they agreed to then.

Jump ahead to these sections:

Don’t fret. As frustrating as the process is, there are some strategies to use to improve your chances of success. Free will and yearning for independence don’t change as people age.

What most people don’t recognize is that a crisis can change the dynamic of free will. A parent falls and breaks a hip and some other bones, goes to rehab, and is told that assisted living is the best option for continued care. Hopefully, with our tips, this won’t happen to your parent. 

Can You or a Doctor Force Someone to Move to Assisted Living?

No one can force someone else to do something against their will. Even with the legal authority granted by guardianship, you cannot physically force someone to change their residence and move to assisted living. However, with guardianship, you can legally move someone to assisted living even if they don’t want to go.

If you are the legal guardian, these decisions can be very challenging. You and your family have to weigh the ethical decision of whether to coerce or otherwise trick someone into moving. There are no easy answers but try first to convince a parent to move before using other methods.

You have been made guardian because your parent may be unable to make informed or reasonable decisions on their own due to incapacity. Whenever possible, try to include your parent in any discussions about a potential move.

A doctor also does not have the authority to force someone into assisted living either. They can recommend and “write a prescription” for assisted living for your parent, but they can’t make them move. However, there are ways in which a physician can help your efforts.

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When Is the Best Time to Talk to a Parent About Moving to Assisted Living?

One thing to keep in mind when choosing the best time to talk to a parent about moving to assisted living is that your urgency may not translate to urgency in your parent’s point of view. They would probably avoid the discussion indefinitely if given a choice. With that in mind, think carefully about the best time to talk to a parent about assisted living. Here are some tips to get you started, and don’t hesitate to be flexible in your approach.

Start talking about assisted living as early as possible

Advanced planning discussions typically involve advance directives, but they should also include future care needs and preferences. The subject of assisted living can also be a bit more relaxed if you are talking about it before it is needed. Broaching the issue in the larger context of advanced planning can help make it less threatening.

Take the time to find out your parent’s preferences and any misconceptions they may have about assisted living. Take a look at finances and discuss the costs of assisted living versus in-home care and be clear about what insurance covers and doesn’t cover.

During a decline or crisis

It seems as though aging decline can be a series of slow crumbles or a crash. A crisis that results in long-term health consequences can create a more urgent and compelling need for assisted living. A slow decline can be more difficult to assess and talk about since there are other supports that can be put in place.

Both of these situations provide a good opportunity to discuss assisted living. If your parent is in the hospital or rehab, staff can support and reinforce a discussion about the advisability of assisted living.

Pick the best time of day

Many older adults tend to be fatigued towards the afternoon and aren’t able to track conversations as well. They also might be grumpy. Other people don’t do well early in the morning. So, think about the best time of day when your parent is alert and fresh. If they cancel plans to discuss assisted living, stay persistent and arrange for another day.

Ways to Talk to or Convince Parents to Move to an Assisted Living Facility

Take a deep breath. These conversations can be hard on everyone involved. Anticipate that there could be strong resistance to the idea of moving to assisted living. 

1. Find out the reasons why

It is common for an older adult to have misconceptions about assisted living. They may equate assisted living with nursing home care, and as a result, have an image of a dark and dingy place inhabited by people in much worse shape than they are.

Other assumptions about assisted living include the idea that everything is very regimented and there is no privacy. Or, you may be worried that your parent won’t like the people there. Our second recommended step can help to dispel many of these notions giving you a better chance of convincing your parent to move.

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2. Visit three assisted living communities

Pick three good assisted living communities to visit. Make an appointment for lunch. Try to get recommendations from your parent’s doctor and any other health care providers, or even friends. Let your parent know that this is only an exploratory expedition to see what an assisted living facility is really like. No commitment will be necessary or expected. 

Meet with the activities director. Your parent may have preferred hobbies or activities, and this can be an excellent way for them to feel connected and to get excited. A scheduled tour will involve looking at rooms, visiting common spaces, and discussing other amenities such as hair salon, physician services, movie theatre, etc.

3. Discuss why assisted living is a good option

An aging parent may refuse help initially and may have difficulty understanding or recognizing how much help they actually need. Losing the ability to function independently is hard to accept. By gently and respectfully pointing out how much care your parent requires, you can help them see things from your perspective.

As the primary caregiver, you may be burned out. The impact on your life, job, and family may not be evident to a parent. Without making your parent feel guilty, try to talk to them and be honest about the stress of taking care of them. Most parents do not want to be a burden on their children. Even if you aren’t the primary caregiver, managing and paying for private care may be unsustainable. 

If necessary, make a list of all your parent’s care needs. Going through these tasks as a family can help shine a light on the reality of the situation. Be specific. If your parent needs help getting dressed in the morning or help bathing, point this out. Talk about how assisted living handles and coordinates care in a way that promotes independence. 

If they don't think assisted living is right for them. You might be able to explore other options. Read our guide on alternatives to assisted living for guidance.

4. Enlist the help of the physician

An older adult can have a great deal of faith in the authority and expertise of their physician. If this is the case, use it to your advantage. Ask the doctor to talk with your parent about the need for assisted living. 

At the next physician appointment, discuss assisted living benefits focusing on health, mood, and general well-being. Call the physician’s office before the visit to let them know that you would like a discussion of assisted living to be part of the appointment. 

5. Be patient and respectful

In your haste to get your parent to assisted living, you might become impatient. Resist this tendency. Understand that you may need several conversations to make an impact and that convincing your parent to move is a marathon, not a sprint. 

Respect is the process of acknowledging and empathizing. There are real and valid fears that drive emotions and affect decisions. Recognize and accept your parent’s feelings so you can address them. Change is hard for anyone, but it can be an enormous deterrent to moving for an older person. 

Talk about each concern and have a plan ready to alleviate these fears. For example, perhaps your parent is worried about downsizing and bringing the items that are important to them. Reassure them that you will store any items that they aren’t willing to give up. 

If you can, stay calm during these discussions. Emotions run high, and your caring and compassionate demeanor will keep the peace and move the conversation forward in productive ways. 

6. Emphasize the benefits

You may want to start by emphasizing that assisted living can enhance independence in ways that your parent may not have considered.  Focus on these benefits:

  • Increased opportunities for physical activity, like exercise classes for seniors.
  • The potential for social connections which can improve mood and prevent loneliness.
  • Many assisted living communities offer in house health providers like podiatrists, dentists, and doctors.
  • Transportation to medical appointments
  • A wide range of recreational activities to suit almost anyone’s taste
  • With individual apartments still plenty of opportunity for privacy

7. Negotiate

In an ideal world, your parent could try out assisted living for several months with the option of changing their mind later. The logistics of such a move and plan may be too hard to pull off, but you could also offer a respite stay in assisted living.

A respite stay is a short-term room rental in assisted living. These rooms are fully furnished. Respite stays are generally used by families going out of town who need someone to oversee their loved one while they are gone.

People in respite care have the full range of amenities and care that any permanent resident would have. A short-term stay can also help your parent get an idea of what assisted living is like. 

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8. Prepare for the worst-case scenario

If respite isn’t an option and you can’t reach a consensus on the subject, ask your parent what they want, and are willing to do to solve the care issues. Ask where they see themselves a few years down the road. Be ready to present some alternatives for discussion that you can both agree on. 

It is possible to consider alternatives to assisted living. No senior living option is perfect, but if you are both willing to augment care with in-home services, it might be worth consideration. Talk about independent senior living with private caregivers, or board and care communities that are homier and more affordable.

If your parent flat out refuses to move, there is nothing you can do except keep trying. Leave the topic for a few days, but don’t hesitate to bring it up again at another time.

Or, if the subject is too charged, discuss the care that your parent needs and how to decrease the stress it is placing on the family. You might just come up with a solution that will buy some time until a move to assisted living becomes inevitable, or your parent changes their mind.  

Tips for Coping When Your Parent Refuses to Move to Assisted Living

When you feel like you are at the end of your rope, what do you do? Despite your best efforts, your parent continues to refuse to move to assisted living, and coping with that perceived sense of failure can be tough. It is normal to feel responsible. But, coming to terms with the decision of not moving to assisted living is healthy for you and for them.

9. Accept your parent’s decision

Accepting without judgment or disappointment is a process, and it is also necessary for you both to move on. People have the right to make bad decisions and suffer the consequences of those decisions. Sometimes by accepting your parent’s choice, it might help to diminish the resistance in the future.

Unfortunately, part of acceptance also means that you will have to pick up the pieces if and when a crisis occurs. Or if your parent continues to deteriorate and safety becomes an even greater issue. Try and do what you can to put supports in place to keep your parent free from harm and as healthy as independent as possible. 

10. Be kind to yourself

You aren’t to blame if you have tried everything you can. Beating yourself up over the issue will only make you feel worse and may even cause you to foster resentment toward your parent.

Being kind to yourself involves coping the best you can despite feeling guilty over accepting your parent’s decision. Remember, they have control as adults and can make their own choices, no matter how you feel or suggest otherwise. It is human nature to want to care for those closest to us, but at some point, letting go and moving on to other ways of showing your love is healthy.

11. Look for support

You are not alone in your disappointment and frustration. If you have siblings or other family members you can talk to, it might help to get their support and counsel. Parents refusing assisted living is more common than you might think, and families struggle with this issue every day.

If your relationship with your parent has deteriorated over this conflict, reach out to a therapist or counselor who can help you repair the relationship and cope with your feelings of disappointment or guilt. By talking with others, you won’t feel so alone.

12. Keep the relationship with your parent positive

Continuing to bring the subject up repeatedly when the response is the same could be detrimental. Leave things alone for a while and focus on the positive aspects of your relationship. Try and prioritize the things you enjoy doing together and show that you respect your parent by honoring their choices, even if you disagree. 

If an Aging Parent Refuses Assisted Living

When an aging parent refuses to move to assisted living, it can set off a cascade of frustrating and conflicting emotions. A strategy that includes compassion, respect, and patience will yield positive results regardless of the outcome.

By working with them to find a solution that will help you both, you can help them retain their wishes while also giving you peace of mind over their safety and health.

If you're looking for more long-term planning resources, read our guides on caring for an aging parent checklist and living with your aging parents.

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